Application

The above applicant is / was in my employ and have found and believe him / her to be of good moral character, of temperate and industrial habits, and in all respects competent to perform the duties of the certification applied for.

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I, the undersigned do certify from my working knowledge of the applicant, that he / she is the person of temperate habits and of good character, and do recommend him / her as a suitable person to be entrusted with the duties  of the occupation for which he / she makes application.  I also attest that he / she has gained the required  experience as contained in his / her application.

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I, the undersigned do certify from my working knowledge of the applicant, that he / she is the person of temperate habits and of good character, and do recommend him / her as a suitable person to be entrusted with the duties  of the occupation for which he / she makes application.  I also attest that he / she has gained the required  experience as contained in his / her application.

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I hereby certify that the statements contained herein are true and correct to the best of my knowledge and belief. I understand that if I knowingly make any false statements herein I am subject to the possible revocation of any certification issued as a result of my false application, and such other penalties as may be prescribed by law.

I also hereby acknowledge this day that I understand that this may be a voluntary certification program, and that I have received notice of the NIULPE, Inc. Regulations and Procedures, and understand and accept the items contained within.

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